[Compartmental syndrome in a traumatized patient under VKA a case report]

Oral anticoagurlation inducing bleeding is a worrying problem because of its frequency and potential gravity. The major determinants of haemorrhage are drug interactions and patient characteristics such as heredity, kind of food and age. Authors report the case of a 76 years old diabetic man with a history of atrial fibrillation treated by vitamin K antagonists [VKA] for more than two years. He presented with a compartmental syndrome of the upper right limb consecutive to a trauma that had been treated by nonsteroidal anti-inflammatory [NSAI] drugs. So he was admitted in an intensive care unit, the NSAI drugs were interrupted and the VKA substituted by low-molecular-weight heparin, while the affected limb was elevated and the patient prepared for operation. But a prolonged prothrombin time [Fr], along with the patient's delayed presentation, were reasons to delay surgery. Course was unusually favourable, nerve suffering signs disappeared and resorption of haematoma was noted. Authors remind in this paper the high risks of drug interactions VKA-NSAI, which can lead to a compartmental syndrome. They also remind the indications of surgical decompression depending on the time of presentation

[Dermatofibrosarcoma protuberans a facial localisation]

The dermatofibrosarcoma protuberans is a rare but not exceptional tumor of the skin. It is misdiagnosed, often after multiple surgical debulking with cosmetic damage. The authors report the case of a 59 years old woman presenting a voluminous dermatofibrosarcoma protuberans located in the parotid area and not associated with facial palsy and trismus. The treatment consisted in a large surgical debulking of the sarcomatous tumor, the covering skin and the superficial lobe of the parotid. The surgeon used local flaps to repair the cosmetic damage. The post operative follow-up was of 1 year without complications and recurrence. Dermatofibrosarcoma protuberans is a cutaneous tumor characterized by local malignancy. It is seen mainly in adults regardless to sex and it is rarely seen in head and neck. This tumor has a rare propensity to metastasise and high relapse and sarcomatous transformation rates, A large debulking is the only solution to avoid a local recurrence